Injury is the leading cause of death for children and thousands of nonfatal injuries are treated in emergency departments every year. Children living in low income urban environments are at especially high risk for preventable injuries. There is promising evidence that pediatric emergency departments can provide an important opportunity for providing injury prevention counseling. We are currently completing an NICHD- funded intervention trial of a culturally tailored, computer kiosk intervention promoting child safety in the Johns Hopkins Pediatric Emergency Department (FED). The families served in this FED are from a low income, urban, predominantly African American population. Preliminary data using the REALM was collected in the RED to inform the development of our intervention. Among 59 parents, 28 percent read below the 9th grade level, and 14 percent at or below the 6th grade level. We have continued to collect REALM data from parents enrolled in the intervention trial, although questions about literacy were not included in the original study aims. Parents (or legal guardians) of young children are being enrolled and randomly assigned to receive the culturally tailored, personalized child safety feedback report or a non-tailored child health feedback report. Outcome assessments of parents' safety knowledge and behaviors will be assessed at two follow-up points by interview with a random sample selected for home observations to confirm self-reported safety practices. This proposed RO3 research is a revised application. The aims are to: 1) assess the prevalence of low health literacy among a large sample of inner city parents of young children seen in a pediatric emergency department; 2) examine the relationship between low health literacy in parents and child injury related outcomes, including knowledge of safety information and adoption of safety behaviors; and 3) examine whether and to what extent low income parents' literacy levels moderate the impact of a culturally tailored computer kiosk intervention on comprehension of safety information and adoption of safety behaviors. Results from this study can be used to: 1) suggest ways in which FED prevention interventions for low literacy populations can be strengthened, and 2) prepare an RO1 application to extend our program of research on adult literacy and child health and safety. We believe communication strategies that effectively incorporate issues of culture and literacy can help reduce the disparities in child injury experiences, although virtually no scholarly work has been undertaken on this topic. We propose to efficiently begin addressing this gap by conducting an innovative secondary data analysis, the results of which will be immediately useful to prevention programs and will form the basis for future research on literacy and child health and safety. [unreadable] [unreadable] [unreadable]